Persistent Depressive Disorder

Depression is an emotional feeling that can affect day to day activity. Individuals describe depression in different ways; for some, it is just sadness, but it is not that simple for others.

A continuous, long-term (chronic) type of depression is a persistent depressive disorder called dysthymia (dis-THIE-me-uh). You can lose interest, feel hopeless, lack productivity, and have low self-esteem and an overall feeling of inadequacy in normal daily activities. These emotions last for years and can interfere greatly with your relationships, education, career, and everyday activities.

If you have a chronic depressive disorder, even on happier occasions, you can find it difficult to be upbeat; you may be identified as having a pessimistic disposition, constantly moaning, or unable to have fun. However, chronic depressive disorder is not as severe as major depression, mild, moderate, or severe, maybe your current depressed mood.

Coping with symptoms of depression may be difficult because of the chronic nature of the persistent depressive disorder. Still, a mixture of talk therapy (psychotherapy) and medication can be successful in treating this disorder.

What is It?

Persistent depressive disorder, dysthymia, a type of depression. It may be less extreme than major depression, but it lasts longer, as the name implies. There are common signs of chronic depressive disorder to those of major depression. In this condition, not really the severity of symptoms is the secret to the diagnosis, but long duration is. The mood can be either low or irritable, as with major depression.

There may be less excitement and a lack of motivation for a person with chronic depressive disorder. He or she may feel unmotivated and relatively disengaged from life. There may be an increase or decrease in appetite and weight. There may also be indecisiveness, pessimism, and bad self-image.

A full-blown episode of major depression can develop into symptoms. There is a greater-than-average chance of developing major depression in people with persistent depressive disorder. Although major depression mostly occurs in episodes, chronic depressive disorder is characterized as more constant, lasting for years.

Often the condition begins in infancy. As a consequence, a person with chronic depressive disorder appears to believe that depression is part of his or her personality and is so self-defining that he or she does not even think of talking to doctors, family members, or friends about this depression.

The persistent depressive disorder appears to run in families, like major depression. It is more common in women than in men, but it could be under diagnosed in men because it is less likely for men to speak about their mood with their doctors. A severe loss in childhood, such as the death of a parent, has been encountered by certain people with chronic depressive disorder. Others report being chronically depressed. But it is also difficult to determine whether people with the condition are under more stress than other individuals or whether they feel more stress than others because of the disorder.

What Causes PDD?

The exact cause of PDD is not known as other causes of depression, but there are a variety of factors that are suspected of playing a role, including:

  • Chemistry of the brain: The balance of brain neurotransmitters may play a role in the onset of depression. These brain chemicals can actually modify certain environmental variables, such as prolonged stress. In order to boost the mood, antidepressants function by adjusting these neurotransmitters.
  • Environmental factors: Depression can also be caused by situational variables like stress, loss, sadness, significant life changes, and trauma.
  • Genetics: Studies indicate that having close family members with a history of depression doubles the likelihood that a person may also develop depression.

In certain situations, to raise the likelihood of experiencing depression, these variables combine.

What Are The Symptoms?

There are very similar signs of chronic depressive disorder to major depressive disorder. These symptoms, however, are persistent, indicating that people experience these depressive symptoms most days for adults for a duration of at least two years and for children and teenagers for one year. Symptoms include the following:

  • Productivity is decreased
  • Thoughts of shame
  • Sentiments of helplessness
  • Thoughts of grief
  • Increases or decreases in hunger
  • Hopelessness
  • Irritableness
  • Lack of energy or tiredness
  • Loss of interest and delight in everyday tasks
  • Low mood
  • Poor self-esteem
  • Difficulties with sleep
  • Social Withdrawal
  • Concentrating difficulty

While people with major depressive disorder can feel better for days or months, those with dysthymia have depressive symptoms for a long time, almost all the time. PDD may have an early onset, with signs that first occur during the age of a child, adolescent, or young adult. In children, depressed mood and irritability are the primary symptoms.

How Is PDD Diagnosed?

The doctor can conduct a detailed medical history and physical examination if depressive symptoms are present. Although there are no laboratory tests explicitly developed to diagnose depressive disorders, diagnostic tests can be used by the provider to rule out physical disease as the cause of depression.

A referral can be made to a psychiatrist or psychologist, mental health practitioners who are qualified to diagnose and treat mental disorders, although no physical condition is detected. To diagnose an individual for a depressive condition, therapists and psychologists use clinical interviewing and evaluation techniques. The psychiatrist or psychologist would then base his or her diagnosis on the patient’s report of symptom severity and length, including any symptom-caused issues with everyday functioning, as well as on observations of the attitude and actions of the patient.

Can Dysthymia Worsen?

Also, having an episode of major depression at the same time is not unusual for a person with dysthymia. I t is known as Double depression. That’s why finding an early, and precise medical diagnosis is so critical. In order to make you feel yourself again, the doctor will then prescribe the most appropriate medication.

Double depression: Major depressive symptoms can also be endured by a person with moderate depression who meets the medical criteria for chronic depressive disorder. However, there is a return to the former state of persistent depression after the major depressive disorder has finished. This PDD and major depressive disorder co-occurrence is often referred to as a double depression.

How to Manage & Treat PDD?

A variety of factors depend on the most helpful form of psychotherapy, including the essence of any traumatic incidents, the availability of family and other social support, and personal preference. Emotional help and education about depression will typically include counseling. Cognitive-behavioral therapy is intended to evaluate faulty, self-critical patterns of thought and help correct them. Psychodynamic, insight-oriented, or interpersonal psychotherapy may assist an individual in crucial relationships to work out problems or discover the background behind the symptoms. Persistent depressive disorder therapies are similar to other depression treatments. Generally speaking, a combination of psychotherapy and drugs is the most effective.

Talk Therapy

A variety of different methods can be used in psychotherapy, but two widely used are cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).

  • CBT: This form of treatment focuses on learning to recognize and modify the underlying negative way of thinking that often leads to feelings of depression.
  • IPT: This therapy is equivalent to CBT but focuses on recognizing relationship and communication issues and then discovering ways to change how you relate to others and communicate with them.


A variety of different forms of antidepressants are eligible to be used for the treatment of PDD, including:

  • Selective serotonin reuptake inhibitors (SSRIs): These medicinal drugs include Zoloft (sertraline) and Prozac (fluoxetine). SSRIs function by raising serotonin levels in the brain, SSRIs function, which can help boost and control mood.
  • Serotonin and norepinephrine reuptake inhibitors (SNRIs): These drugs include Cymbalta (duloxetine) and Pristiq (desvenlafaxine). SNRIs works by raising the amount of serotonin and norepinephrine in the brain.

To treat dysthymia, there are various types of antidepressants available. Your doctor will examine your physical and mental health, including any other medical problems, and then find the most appropriate antidepressant with the least side effects. Older antidepressants like tricyclic antidepressants and monoamine inhibitors are still in use, and for those that do not react to the new drugs, they may be quite efficient. In all, there are hundreds of available antidepressants. Depending on the case, some might be worth trying. Usually, to see progress requires two to six weeks of antidepressant usage. Usually, the dosage needs to be changed to find the correct dose for you. In addition, it may also take several weeks to safely discontinue an antidepressant, so let your doctor guide you if you want to quit the medication. It may take up to a few months for the full positive effect to be seen. Even for you, the first drug could not work. Before discovering one that offers relief, you may need to try several different antidepressants. Two different antidepressant drugs are often administered together, or your doctor can add a different class of medicine to your care, such as a mood stabilizer or anti-anxiety medicine. Occasionally, low-dose antipsychotic medication is very effective for symptoms that are otherwise resistant to therapy. Finding the combination that works best may also require patience. Moreover, it can often take several weeks for an antidepressant to be stopped safely, so let your doctor guide you if you plan to discontinue the medication. Antidepressants sometimes have uncomfortable side effects. This is why you have to work closely with your doctor to find the most effective antidepressant with the least side effects.

In cases of mild-moderate depression, St. John’s Wort, which has been stated to be useful, is often used as a self-help remedy. Although St. John’s Wort and other natural treatment methods tend to work for some people with depression, without talking to your doctor first, it’s crucial that you never take any supplements. This herbal remedy can lead to a hazardous complication known as serotonin syndrome when combined with antidepressants.

How to Cope With PDD?

To better deal with chronic depression, there are a variety of different things that individuals can do. Since this kind of depression is persistent, it may be helpful to combine lifestyle changes and self-care with your medical treatments. Supplement therapy and medication, which include:

  • Stop alcohol and other substances.
  • Build pregame chores that allow your day to be organized.
  • Follow a balanced diet.
  • Establish a coherent routine for sleep.
  • Give yourself daily exercise several times a week.
  • Leave the house and set a plan with your friends.
  • Practice strategies of stress control, such as deep breathing and meditation.

When you are feeling sad, it can be hard to do many of these things. Although it can be a war, note that you don’t have to do it perfectly. In your mood and attitude, even minor adjustments can make a difference. You could start by making small goals, for example, and then gradually build on them over time.

Risk Factors

The persistent depressive disorder frequently starts early and is persistent in pregnancy, teenage years, or young adult life. The risk of developing or causing persistent depressive disorder appears to be increased by several variables, including:

  • Getting a relative of the first degree of major depressive or other depressive disorders
  • Traumatic or stressful events in life, such as a loved one’s death or financial difficulties
  • Personality features, such as low self-esteem and becoming too dependent, self-critical, or negative, including negativity.
  • A history of other disorders of mental health, such as personality disorder


Conditions that may be associated with the depressive chronic disorder include:

  • Reduced Life Quality
    Significant depression, disorders of anxiety, and other mood disorders
  • Abuse of substances
  • Difficulties with marriages and family issues
  • Problems with school and job and reduced efficiency
  • Chronic fatigue and general medical diseases
  • Suicidal thoughts or actions
  • Personality disorders or other compromised mental health

The Outlook

The outlook for those with this condition is outstanding with care. The length and severity of symptoms are also greatly reduced. The symptoms go away entirely in many people. The disorder is more likely to persist without treatment, the person is likely to have a decreased quality of life, and has an increased risk of developing severe depression. Even if treatment is successful, maintenance therapy is also needed to avoid the return of symptoms.